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VIRCHOWS ARCHIV 2025年第1期486卷 65-79页

作者： Bode, Peter Karl Blasco-Santana, Luis Colmenero, Isabel Reyes-Mugica, Miguel Kantonsspital Winterthur Dept Pathol Winterthur Switzerland Hosp Infantil Univ Nino Jesus Dept Histopathol Madrid Spain Univ Miami Dept Pathol Miller Sch Med Miami FL USA Univ Miami Lab Med Miller Sch Med Miami FL USA

Pediatric germ cell tumors represent a rare but biologically diverse group of neoplasms arising from pluripotent primordial germ cells. The 2022 edition of the WHO Classification of Pediatric tumors introduced the first organ independent classification of germ cell tumors, reflecting advances in molecular biology, histopathology, and clinical practice. This review highlights the key changes, including the refined distinctions between the different subtypes. These updates enhance diagnostic accuracy and provide a framework for understanding age-dependent differences in tumor biology and behavior. Emphasis is placed on integrating the new classification into multidisciplinary care, particularly in addressing diagnostic challenges in pre- and post-pubertal-type germ cell tumors. By bridging the gap between histopathology and oncology, the updated classification represents a pivotal step forward in improving outcomes for children with germ cell tumors.

关键词： germ cell tumors WHO classification of pediatric tumors germinoma Teratoma Yolk sac tumor OCT3/4

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germ cell tumors

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Medicine (Spain) 2021年第26期13卷 1467-1472页

作者： García, L. Bernier Cendra, C. Sánchez Mohedano, N. Mohedano Veiga, M. Peñas Pita da Arrija, I. Nalda Espinosa, J. Cassinello Unidad de Oncología Médica Hospital Universitario de Guadalajara Guadalajara Spain

Testicular germ cell tumors (TGCT) are rare and represent only 1% of all malignant tumors in males, but are the most frequent neoplasm in individuals between 15 and 35 years of age. Its worldwide incidence has increased in recent years and the mortality rate has gradually decreased thanks to advances in modern chemotherapy, improvements in supportive care, earlier diagnosis, and cumulative experience in its comprehensive treatment. It has a general 5-year survival rate of 95%. Treatment is based on surgery and well-established chemotherapy schedules. At the moment, no new generation drugs are available, perhaps due to reticence to try a new treatment when there is one that is already consolidated and with a high degree of definitive recovery. In fact, these tumors can be considered a model par excellence for cancer cures. © 2021

关键词： Classic chemotherapy germ cell tumors Incidence Model of recovery Staging

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Efficacy and safety of modified bleomycin administration with EP chemotherapy in adult male patients with germ cell tumors: a retrospective study

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CANCER cell INTERNATIONAL 2025年第1期25卷 1-10页

作者： Shu, Ditian Huang, Riqing Chen, Meiting Li, Haifeng An, Xin Xue, Cong Hu, Anqi Zhou, Fangjian Yao, Kai Liu, Zhuowei Shi, Yanxia Sun Yat Sen Univ Guangdong Prov Clin Res Ctr Canc State Key Lab Oncol South China Canc Ctr Guangzhou 510060 Peoples R China Sun Yat Sen Univ Dept Med Oncol Canc Ctr 651 Dongfeng East Rd Guangzhou 510060 Peoples R China Sun Yat Sen Univ Canc Ctr Dept Urol 651 Dongfeng East Rd Guangzhou 510060 Peoples R China

Background Given the substantial inconvenience caused by weekly bleomycin administration, we initiated a study to evaluate the efficacy and toxicity of the modified bleomycin combined with EP (modified-BEP) regimen in Chinese adult male patients with germ cell tumors (GCTs). Methods We conducted a retrospective analysis of 274 adult male GCT patients treated with modified-BEP at the Sun Yat-sen University Cancer Center between 2005 and 2022. The regimen involved a tri-weekly 5-day schedule with 30 IU modified bleomycin (administered on days 1, 3, and 5), 20 mg/m2 cisplatin (days 1-5), and 100 mg/m2 etoposide (days 1-5). The survival rates and safety profiles of the patients were analyzed. Results Among the patients, 42 patients received BEP in adjuvant setting, while 232 were treated with BEP in curative setting. With a median follow-up of 41.03 months among the curative patient population, the 5-year progression-free survival (PFS) rate was 79.33%, and the 5-year overall survival (OS) rate was 86.26%. Stratified by the International germ cell Cancer Collaborative Group (IGCCCG) prognostic groups, the 5-year OS rates of the good, intermediate, and poor risk groups were 99.05%, 92.84%, and 55.96% (P < 0.0001), respectively. Favorable responses, including complete remission and partial response with negative tumor markers, were achieved in 91.07% of good-risk, 84.13% of intermediate-risk, and 52.63% of poor-risk patients, with a significant difference (P < 0.0001). Multivariate analysis indicated that non-seminoma, poor risk group, mediastinal primary tumor, and Eastern Cooperative Oncology Group (ECOG) 2 status were significantly associated with inferior PFS. In the entire cohort, major grade 3-4 adverse events included neutropenia (38.69%), anemia (4.74%), thrombocytopenia (5.11%), and febrile neutropenia (6.2%), with no death due to pulmonary toxicity. Conclusion The modified-BEP regimen showed an effective and tolerable treatment alternative for adult male GCT pat

关键词： germ cell tumors Modified chemotherapy Pulmonary toxicity BEP

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Current Role of MicroRNAs in the Diagnosis and Clinical Management of germ cell tumors

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Surgical Pathology Clinics 2025年第1期18卷 91-100页

作者： Tavares, Nuno Tiago Henrique, Rui Jerónimo, Carmen Lobo, João Cancer Biology and Epigenetics Group IPO Porto Research Center (GEBC CI-IPOP) Portuguese Oncology Institute of Porto (IPO Porto)/Porto Comprehensive Cancer Center Raquel Seruca (P.CCC) & CI-IPOP@RISE (Health Research Network) IPO Porto Research Center CI-LAB3 1st Floor F Building. Rua Dr. António Bernardino de Almeida Porto 4200-072 Portugal Doctoral Programme in Biomedical Sciences ICBAS - School of Medicine and Biomedical Sciences University of Porto Rua Jorge Viterbo Ferreira 228 Porto 4050-513 Portugal Department of Pathology and Molecular Immunology ICBAS - School of Medicine and Biomedical Sciences University of Porto Rua Jorge Viterbo Ferreira 228 Porto 4050-513 Portugal Department of Pathology Portuguese Oncology Institute of Porto (IPO Porto)/Porto Comprehensive Cancer Center Raquel Seruca (P.CCC) R. Dr. António Bernardino de Almeida Porto 4200-072 Portugal

Abstractgerm cell tumors (GCTs) are a rare and heterogeneous group of neoplasms arising from primitive germ cells. MicroRNAs are small noncoding RNAs that have emerged as potential cancer biomarkers in the last decade. In particular, miR-371a-3p has shown good diagnostic performance for germ cell neoplasia in situ-derived testicular GCTs in several well-established cohorts and is expected to enter the clinical arena in the near future. GCTs universally exhibit high expression of miR-371-373 and miR-302/367 clusters and low expression of let-7 family miRNAs. Further studies are needed to assess the potential role of these miRNAs as biomarkers of ovarian and extragonadal GCTs.

关键词： Biomarkers germ cell tumors Liquid biopsies microRNAs miR-371a-3p Testicular cancer

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Outcome and recurrence patterns of low-risk gonadal germ cell tumors in children and adolescents

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Pediatric Hematology Oncology Journal 2025年第1期10卷 51-56页

作者： Courtel, Tiphaine Chabaud, Sylvie Orbach, Daniel Sudour-Bonnange, Hélène Verité, Cecile Rome, Angelique Dumesnil, Cecile Fresneau, Brice Thebaud, Estelle Renard, Marleen Barry, Aissatou Hameury, Frederic Dijoud, Frederique Conter, Cecile Faure Institut d'Hemato-oncologie Pediatrique Department of Pediatric Oncology Lyon France Statistical unit Clinical Research department Centre Léon Bérard Lyon France SIREDO Oncology Center (Care Innovation and Research for Children Adolescents and young Adults with Cancer) Institut Curie PSL University Paris France Pediatric and Adolescents Oncology Unit Anti-Cancer Center Oscar Lambret Lille France Pediatric Hematology-Oncology Unit Pellegrin Hospital CHU Bordeaux Bordeaux France Department of Pediatric Oncology of Timone Children's Hospital Marseille France Department of Pediatric Oncology. University Hospital Center of Rouen Rouen France Gustave Roussy Université Paris-Saclay Department of Children and Adolescent Oncology Paris-Saclay University Paris-Sud University CESP INSERM Villejuif France Department of Pediatric Oncology. University Hospital Center of Nantes Nantes France Department of Paediatric Hemato-oncology University Hospital Leuven Belgium Hôpital Femme Mère Enfant Department of Pediatric Surgery Lyon France Institut Multisite de Pathologie CHU de Lyon France Unité d'Onco-Hémato-Immunologie pédiatrique CHU Angers Angers France

Pediatric low-risk gonadal germ cell tumors (LR-GCTs) are typically managed with close surveillance following surgery alone. However, the patterns of relapse and prognostic factors for relapse remain insufficiently understood. We reviewed 72 patients under 19 years old diagnosed with low-risk ovarian (OGCT) or testicular (TGCT) GCT between May 27, 2014, and December 31, 2022, from the TGM13-observatory (EudraCT 2013-004039-60). Among 30 OGCT (median age 13 years), 15 were dysgerminomas and 15 were non-dysgerminomatous OGCT (NDOGCT), with 10 patients having incomplete abdominal staging. Eleven relapses were observed, nine of which were locoregional. The three-year progression-free survival (PFS) was 73 % (95 % CI: 44–89) for dysgerminomas and 53 % (95 % CI: 26–74) for NDOGCT (p = 0.22). Among the 42 testicular tumors (median age 3 years), all but one were NSGCTs. Ten relapses occurred, resulting in one death. The three-year PFS for testicular GCTs was 76 % (95 % CI:59–86). Relapse patterns differed by age: in toddlers, relapses predominantly occurred in the lungs, while in adolescents, relapses were primarily in the para-aortic lymph nodes. The median time to relapse was six months. No significant prognostic factors for relapse were identified, including older age (>11 years), incomplete staging for OGCT, and the presence of lymphovascular invasion or embryonal carcinoma for TGCT. Survival after relapse remains excellent, and further research with a larger sample of children is needed to better identify risk factors for relapse in pediatric LR-GCTs. © 2025 Pediatric Hematology Oncology Chapter of Indian Academy of Pediatrics

关键词： Chemotherapy Children germ cell tumors Gonadal Risk factors Stage I

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Spectrum of Somatic Malignancy in Testicular germ cell tumors-A Histopathological Review of 25 Cases with Clinical Outcome

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INDIAN JOURNAL OF MEDICAL AND PAEDIATRIC ONCOLOGY 2025年第2期46卷 174-182页

作者： Subramanian, Priyadarsani Arora, Amandeep Pal, Mahendra Prakash, Gagan Maitre, Priyamvada Murthy, Vedang Joshi, Amit Rane, Swapnil Desai, Sangeeta Menon, Santosh Homi Bhabha Natl Inst Tata Mem Ctr Dept Pathol Mumbai 400012 Maharashtra India Homi Bhabha Natl Inst Tata Mem Ctr Dept Urol Mumbai Maharashtra India Homi Bhabha Natl Inst Tata Mem Ctr Dept Radiat Oncol Mumbai Maharashtra India Homi Bhabha Natl Inst Tata Mem Ctr Dept Med Oncol Mumbai Maharashtra India

Introduction germ cell tumors (GCTs) are the commonest testicular malignancy in young males. These tumors are highly chemoresponsive, however become resistant to conventional therapy when a somatic-type malignancy (SM) develops, which happens in similar to 3 to 6% of the cases. Methods We reviewed the histologic profile of all cases of testicular/retroperitoneal GCT with SM, diagnosed over a period of 12 years in our institute. Correlation of histologic profile with clinical outcome was done wherever feasible. Results A total of 25 cases of testicular/retroperitoneal GCT with SM were identified for review. The histological spectrum of SMs included carcinoma ( n = 9), sarcoma ( n = 9), embryonic-type neuroectodermal tumor (ENET) ( n = 4), and other rare histological types ( n = 3). SMs were frequently seen at the resected metastatic sites ( n = 13) and in postchemotherapy setting ( n = 12);14 cases had concurrent GCT and SM at the time of diagnosis/initial resection and 9 cases presented as late relapses (more than 2 years after initial presentation). Four patients were treated with metastasectomy and lymph node dissection, six patients were treated with combined resection and chemotherapy, and nine patients were treated with only adjuvant chemotherapy. The patients with SM confined to testis and those treated with multimodality approach had relatively better outcome. Conclusion GCTs with SM are a highly heterogeneous group of tumors with varying histologic types and management strategies. Strict adherence to histological diagnostic criteria, differentiating these tumors from close mimics such as glandular and sarcomatoid yolk sac tumors, teratomatous overgrowth, and a new second primary somatic tumor are important due to implications in management and prognosis.

关键词： germ cell tumors somatic malignancy embryonic-type neuroectodermal tumors rhabdomyosarcoma teratomatous overgrowth

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Prediction Model for Brain Metastasis in Patients With Metastatic germ-cell tumors

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CANCER MEDICINE 2025年第3期14卷 e70649页

作者： Salous, Tareq Ashkar, Ryan Althouse, Sandra K. Cary, Clint Masterson, Timothy Hanna, Nasser H. King, Jennifer Einhorn, Lawrence H. Adra, Nabil Indiana Univ Simon Comprehens Canc Ctr Div Hematol Oncol Indianapolis IN 46202 USA Indiana Univ Dept Biostat & Hlth Data Sci Indianapolis IN USA Indiana Univ Sch Med Dept Urol Indianapolis IN USA

Background Brain metastasis (BM) is an independent adverse prognostic factor in metastatic germ cell tumors (mGCT). We aimed to establish an effective and practical BM prediction model. Patients and Methods Between January 1990 and September 2017, 2291 patients with mGCT who were treated at Indiana University were identified. Patients were divided into two categories: BM present (N = 154) and BM absent (N = 2137). Kaplan-Meier methods were used to analyze progression free survival (PFS) and overall survival (OS). Logistic regression was used to determine a predictive model for whether BM was present. The data was separated into training and validation datasets with equal numbers of events in each. Results The 2-year PFS and OS for patients with versus without BM: 17% versus 65% (p < 0.001) and 62% versus 91% (p < 0.001) respectively. Among the 154 patients with BM, 64 (42%) had radiation only (whole-brain radiotherapy or gamma knife), 22 (14%) had BM-surgery only, 14 (9%) had both radiation and BM-surgery. 54 patients (35%) did not receive local therapy for BM. Stepwise selection was used to determine the best model with p < 0.15 as the entry and staying criteria. The model with the largest ROC AUC was used moving forward. The model was tested in the validation dataset. A model was generated including age at diagnosis >= 40, choriocarcinoma predominant histology, pre-chemotherapy hCG >= 5000, presence of pulmonary metastases size < 3, or >= 3 cm, and presence of bone metastasis. Patients with score of 0, 1, 2, 3, 4, 5, 6, 7, 8 points had a 0.6%, 1.4%, 3.5%, 8.2%, 18.3%, 36%, 58%, 78%, 90% probability of having BM, respectively. Conclusions The prediction model developed in this study demonstrated discrimination capability of predicting BM occurrence in mGCT and can be used to identify high-risk patients.

关键词： brain metastasis germ cell tumors prediction model prognosis

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germ cell tumors of the central nervous system originating from non-pineal regions: CT and MR features

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COMPUTERIZED MEDICAL IMAGING AND GRAPHICS 2000年第4期24卷 269-276页

作者： Tomura, N Takahashi, S Kato, K Okane, K Sashi, R Watanabe, O Watarai, J Ito, Y Mizoi, K Akita Univ Sch Med Dept Radiol Akita 0108543 Japan

CT and MR findings were retrospectively reviewed in 12 patients with germ cell tumors originating from the non-pineal regions. Cystic or necrotic components were seen in 6 patients. Of 4 germinomas, 2 showed mixed density on the CT. The MR signal intensity of the tumor was non-specific. Of 8 germinomas, 4 were inhomogeneously enhanced on postcontrast CT and T1-weighted MR images. CT and MR features of germinomas originating from non-pineal regions frequently differ from those of germinomas originating from the pineal region. The mass of the tumor often appeared cystic and inhomogeneously enhanced following contrast infusion. (C) 2000 Published by Elsevier Science Ltd. All rights reserved.

关键词： MR imaging CT germ cell tumors central nervous system non-pineal region

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germ cell tumors of the testis

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ANNALS OF SURGICAL ONCOLOGY 2005年第11期12卷 871-880页

作者： Carver, BS Sheinfeld, J Mem Sloan Kettering Canc Ctr Dept Urol New York NY 10021 USA

Testicular cancer is the most common malignancy in men aged 20 to 35 years and accounts for approximately 1% of all male malignancies. Through the appropriate utilization of clinical trials, effective treatment paradigms have been developed for the management of all stages of testicular cancer. The multidisciplinary approach to the management of germ cell tumors of the testis has resulted in survival rates of > 90% overall. This review summarizes the principal management of germ cell tumors of the testis, highlighting the indications for surgery, controversies surrounding the integration of surgery, and alternative management strategies.

关键词： testicular cancer primary retroperitoneal lymph node dissection chemotherapy germ cell tumors

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germ cell tumors of the mediastinum and testis: A comparative immunohistochemical study of 120 cases

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HUMAN PATHOLOGY 1998年第7期29卷 737-742页

作者： Suster, S Moran, CA Dominguez-Malagon, H Quevedo-Blanco, P Mt Sinai Med Ctr Dept Pathol & Lab Med Miami FL USA Univ Miami Sch Med Miami FL USA Armed Forces Inst Pathol Dept Pulm & Mediastinal Pathol Washington DC 20306 USA Natl Canc Inst Mexico City DF Mexico

An immunohistochemical study was performed in 120 cases of mediastinal and testicular germ cell tumors from archival, paraffin-embedded material to compare the patterns of expression between the two groups with a panel of markers, including broad-spectrum keratin, CAM 5.2 low-molecular weight cytokeratin, placental-like alkaline phosphatase (PLAP), alpha-fetoprotein (AFP),human beta-chorionic gonadotropin (hCG),vimentin, and CD30 (Ki-l antigen). Significant differences were observed between mediastinal and testicular seminomas: mediastinal seminomas showed strong dot-like paranuclear positivity of the tumor cells with antibodies to CAM 5.2 low-molecular-weight keratin in 80% of cases (32 of 40), as compared with only 20% positivity (5 of 24) in testicular seminomas;placental alkaline phosphatase (PLAP) was also found to be less commonly expressed in testicular seminomas (12 of 24) than in mediastinal seminomas (37 of 40);a similar pattern of expression was also observed for vimentin, which was present in scattered tumor cells in a higher proportion of mediastinal seminomas (28 of 40) than in testicular seminomas (11 of 24). The staining pattern and distribution of these markers did not show significant differences between the two groups for the various other tumor categories studied, including yolk sac tumor, embryonal carcinoma, and choriocarcinoma. The tumor cells in both testicular and mediastinal embryonal carcinoma showed strong positivity for the CD30 antigen;however, strong positivity for this marker was also observed in 6 of 25 yolk sac tumors and in scattered individual tumor cells in 4 of 63 seminomas. The results of this study show that significant differences exist between the immunostaining patterns of mediastinal and testicular seminomas, suggesting that the former may be characterized by a more mature phenotype than their testicular counterparts. Also, CD30 expression may not be necessarily restricted to embryonal carcinomas and occasionally may be ob

关键词： germ cell tumors mediastinum immunohistochemistry CD30 seminoma

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